Yeah, I’ve had the experience of paying off a bill, only for the hospital to, about a year later, send us a newly adjusted bill from the same encounter where they discovered we actually owed them a further three hundred. Healthcare is the only field where this kind of shit is tolerated as a routine matter. Any other business doing that would be shamed in town square, but it’s Tuesday for healthcare.
Okay, so the American system is an employer based model, meaning that your health plan, if you have one, is determined by your employer. This means a few key things:
Your plan may (and probably does) vary wildly in nearly every regard from someone else’s despite both of you being with the same insurer.
You are not the customer, but the user. Your boss is the customer. As such, the insurance company doesn’t really care if they piss you off, because you can’t just fire them and go with some other plan. They only care about not pissing off your boss. Well, you can technically, but individual insurance is so expensive and bad (and there’s only a few big players in the market anyway) that it’s an obviously better choice to just get jerked around by your employer’s plan.
The entire healthcare payment process is so arcane, unintuitive, and complex that no lay person outside the system can be really expected to navigate it if someone says “whoops, we’re not paying because the florp code was misapplied during Venus Wednesdays, and though you flipped your florp last month, some businesspeople made a deal just last week to agree that florps will only be covered by approved Todds (the closest is a convenient 600 miles from you). This judgment is final, may God have mercy on your soul.” As an example, I’ve had insurance pre-approve something and then turn around and deny it once it got billed, and because I didn’t think to get physical proof of pre-approval first, the insurance basically just ended it with “nuh uh, we never said that, do you have a receipt?” Lesson learned. And a lot of times, the people inside of it don’t have the full picture. There are people whose entire profession is either arguing with insurance companies all day to force them to pay what’s due, or helping patients navigate the system. It makes it really, really easy to rip off both patients and health providers.
Government insurance like Medicare also sucks. Their reimbursement rates are terrible, among other factors, and it’s caused more and more providers (those who can choose, anyway) to stop seeing these patients, meaning that you start ending up with a few Medicaid clinics whose soonest appointment is months from now and spend about 20 seconds per patient. This is largely a result of our conservatives trying to prove that government doesn’t work by making the government not work. Just so we’re clear, private insurance holders also have long wait times and doctors that are pressed for time, it just tends to be a little less bad.
Since insurers have figured out that there’s money to be gouged in medication, they’ve gotten into the mail order pharmacy and pharmacy Benefit manager (if you want to get a tummy ache, read up on PBMs, they’re the biggest bastards in a field full of absolute bastards) game. Since then, they’ve managed to kill off most small business pharmacies and turn just getting your medication into the same bureaucratic, clown energy pain in the ass as trying to arrange an MRI. (YMMV by insurer, plan, medication, etc)
On top of all that, about a decade or two back, private equity figured out that healthcare in the US is practically a license to print money, so they’ve come in, taken all kinds of stuff over, made everything worse for everyone involved but the businesspeople, all while jacking up prices and cutting services. Yaaaaaaaaay
Dr. Glaucomflecken on YouTube provides a pretty good (and funny / simultaneously infuriating) insight into the mess of healthcare in the US from a providers perspective.
You’re not really using the fediverse until you’ve been told that you’ll get the bullet, too. Sometimes, it’s exhausting commenting something pretty uncontroversial and then seeing like eight notifications and realizing it was on Hexbear.
Well, yeah. It’s obviously better to spend even more money in the long-term constantly chasing and harassing the homeless with police. We just don’t have money for solutions, which is why we’re going to spend even more money on non-solutions.
We have a second house (a trailer, really) and rent it to my mom for way under market rate. 100% of the rent goes to paying off the debt from rehabilitating the trailer and paying off her utilities. It’s not like we’re out here just raking in the dough, we’re just trying to keep my mom from being homeless. I know for damn sure we’ve got to do it, because the state is way happier spending its money bashing homeless people instead of preventing homeless people.
Real talk, it’s going to be like the troubles or the early days of Nazi Germany, not like people forming battle lines and shit. The only way the latter happens is if states secede; one viable scenario I’ve considered is California/Pacifica seceding and a subsequent shooting fight over water rights, because of how much water California gets from the Colorado River basin and other water sources outside its borders. But realistically, it’s going to be shitty partisan on partisan on innocent bystander violence.
Best advice I’ve heard is to form close ties and mutual aid agreements with your neighbors and friends. A small network of people can be far, far, far more resilient in defending protecting themselves than individuals or families can.
This is a mixed bag. Where I get lukewarm is that I’m convinced it’s going to come down to a shooting fight with the fascists at some point, and I’d rather that the people who are not fascists be able to educate and arm themselves appropriately. Don’t bring sticks and bricks to a gun fight and all that.
Sure, I’d welcome Biden changing my mind on this.
I think it’s a little alarming that his last international travel was almost two weeks pre-debate and that left him tired enough to perform badly. And by badly, I mean the worst debate performance I’ve seen ever, and I’ve been watching since Bush/Kerry. I also don’t think it bodes well that he hasn’t yet done any big interviews or press conferences to show that it really was just a fluke, which seems like a fairly easy thing to do if he really is actually fine. I would feel much better about his odds of beating Trump if he could start reliably doing public speaking at a similar quality to what he displayed in 2020, which remains to be seen a whole week later.
The difference is that Biden has markedly declined from previous performances. He spent most of that night stumbling, mumbling, and struggling to speak clearly, none of which is his stutter, because a stutter is a very specific speech impediment. He was downright difficult to understand on average, and flat out unintelligible at worst. Even when he got riled up, like with the losers and suckers remark, it sounded like he was having trouble forming word sounds accurately, like he has dysarthria. Even in carefully curated campaign material, like asking for donations, he sounds out of breath and like he’s struggling to speak clearly.
I think the part where he finally beat medicare is the best example.
I would gladly have Trump drop out. It won’t happen. Trump is running to save his own ass. For my part, I have grave doubts about Biden’s ability to win that have been building for a few months but came sharply into focus during the first minute of that debate.
I keep seeing this sentiment, and it boggles me. Last season’s winning horse just debuted this season with a huge limp, and the response from some people has been “it’s fine, stop panicking, we’ll win if we just keep betting on it.”
It’s not like the protests just went nowhere and petered out. That was the effect, but the state showed that it has a violent and psychotic response to any serious criticism, and was unashamed of it.
The one about cows is no joke. Hitting a cow in a sedan at highway speeds is more or less the same as hitting a brick wall.
Edit: actually, given the choice, take the brick wall, because at least a simple masonry wall will crush and crumble and absorb some of the impact. The cow will just gain a sudden increase in its net velocity at your expense.
Calm down, satan
And rubber chickens, apparently. The secret service went around confiscating them at Trump’s libertarian party speech.
It’s on the first page of the bill and runs into the second page if you open the full document.
Is it just me or are modern cock n balls renditions getting sadder? These don’t look all that proud to me.
I was going to make a remark about how getting a permit must be really convenient, since you don’t even need to leave the office.
Yep, that’s me. You could probably find a few more good examples of me stepping in shit on Hexbear, that’s hardly the first.